2001 issue 2

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Volume 10, issue 2

Systemic connective tissue diseases

Neurological and psychiatric manifestations in SLE patients with and without the antiphospholipid syndrome

ANNA JĘDRYKA-GÓRAL1, ARLETTA KUCZYŃSKA-ZARDZEWIAŁY2, HENRYKA MAŁDYKOWA1, HANNA CHWALIŃSKA-SADOWSKA1, Anna Członkowska2
1. Kliniki Chorób Tkanki Łącznej Instytutu Reumatologii w Warszawie
2. Kliniki Chorób Naczyń Instytutu Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii, 2001, 10, 145-150
Keywords: systemic lupus erythematosus, antiphospholipid syndrome

Abstract

Neurological and psychiatric symptoms of SLE (NP-SLE) include a wide spectrum of the nervous system events that may lead to the patient's disability or even death. The aims of the study were: to determine the prevalence of NP manifestations in SLE patients with and without APS, and to analyze the usefulness of MR and CT techniques in the diagnosis of CNS lupus. 58 consecutive SLE patients were evaluated (54 F, 4 M, mean age: 40.4±15.5 years). In 50 patients the diagnosis of SLE and in 8 patients – SLE+APS was made. NP-SLE manifestations were diagnosed in 28 cases, i.e. 48% of patients. Cerebrovascular events (TIA, complete stroke, intracerebral hemorrhage) were present in 12 patients, migraine – in 11, peripheral neuropathies – in 7, psychiatric disorders – in 6, emotional distress – in 4, and motor disorders – in 3 patients. Other manifestations (epilepsy, dementia, cognitive impairment, sleeplessness) were observed in single cases. In 82% of patients NP symptoms were present from the onset of SLE. In the NP-SLE group the mean age was similar to that of other patients, i.e. 41.8 vs. 39.2 years, whereas the mean duration of the disease was much longer, i.e. 95.9 vs. 40.2 months. All 4 male patients were in the NP-SLE group. In the SLE+APS group NP symptoms were found in 7 (88%) patients, but only in 3 of them (43%) - from the beginning of SLE. In 20 patients MR and CT examinations were performed. In CT – 2 patients had multiple ischemic infarcts, 1 – intracerebral hemorrhage, 7 – slight or moderate cerebral atrophy. MR showed focal lesions in 10 patients (multiple ischemic changes – in 7 cases, single – in 2, multiple i.ch. with intracerebral hemorrhage – in l case, and atrophy in 5 patients). In this study a wide spectrum of NP manifestations was observed. The concurrent APS increased the risk of NP manifestations in SLE patients. MR turned out to be more useful than CT in diagnosing CNS lupus, regardless of the presence or absence of APS.

Address for correspondence:
Prof. Anna Jędryka-Góral,
Zakład Ergonomii Centralnego Instytutu Ochrony Pracy,
ul. Czerniakowska 16,
02-701 Warszawa